Abstract: In one embodiment of the invention, a replaceable electrosurgical end effector cartridge is provided to couple to a mechanical wrist of a surgical instrument for a robotic surgical system. The replaceable electrosurgical end effector cartridge includes two end effectors, a fastener to rotatably couple the two end effectors together, and a cam mechanism. At least one of the two end effectors is a moveable end effector having a jaw portion, an off-center portion, and a base portion. The cam mechanism is coupled to the base portion of the at least one moveable end effector to pivot it about the fastener to open and close the jaw portion of the at least one moveable end effector with respect to the other.

Abstract: Apparatus and methods for treating conditions such as rhinitis are disclosed herein where a distal end of a probe shaft is introduced through the nasal cavity where the distal end has an end effector with a first configuration having a low-profile which is shaped to manipulate tissue within the nasal cavity. The distal end may be positioned into proximity of a tissue region having a post nasal nerve associated with a middle or inferior nasal turbinate. Once suitably positioned, the distal end may be reconfigured from the first configuration to a second configuration which is shaped to contact and follow the tissue region and the post nasal nerve may then be ablated via the distal end. Ablation may be performed using various mechanisms, such as cryotherapy, and optionally under direct visualization.

Abstract: The present disclosure is directed to an electrosurgical generator including a tank configured to output energy and an H-bridge configured to drive the tank. The generator also includes a choke. The choke impedes a common mode current generated by the H-bridge and provides a leakage inductance for the tank.

Abstract: Electrosurgical cannulas for use with an electrosurgical generator to thermally treat tissue are disclosed. An electrosurgical cannula for use with an electrosurgical generator to treat tissue is provided. The electrosurgical cannula includes a cylindrical body portion defining a lumen therethrough. The body portion includes a non-coring pointed distal tip which is electrically conductive. The electrosurgical cannula further includes at least one thermocouple having a distal end connected to the conductive distal tip.

Abstract: An irrigated catheter includes a catheter body having both proximal and distal irrigation passageways. A first fluid delivery tube feeds the proximal irrigation passageway and is fluidly isolated from the distal irrigation passageway, while a second fluid delivery tube feeds the distal irrigation passageway and is fluidly isolated from the proximal irrigation passageway. Typically, the first and second fluid delivery tubes will be unitary, at least through the catheter body. The overall shape of the first and second fluid delivery tubes, as well as their respective lumens, may vary as necessary for a particular application of the irrigated catheter. The system also includes an irrigation fluid source and at least one pump to deliver the irrigation fluid through the irrigation passageways. Typically, the pump will be a volume-driven pump, such as a rolling pump.

Abstract: An embodiment of the invention includes a surgical device for coagulating soft tissue such as atrial tissue in the treatment of atrial fibrillation, atrial flutter, and atrial tachycardia; tendon or ligament shrinkage; or articular cartilage removal. The surgical device integrates a suction mechanism with the coagulation mechanism improving the lesion creation capabilities of the device. The surgical device comprises an elongate member having an insulative covering attached about conductive elements capable of coagulating soft tissue when radiofrequency or direct current energy is transmitted to the conductive elements. Openings through the insulative covering expose regions of the conductive elements and are coupled to lumens in the elongate member which are routed to a vacuum source. Suction causes the soft tissue to actively engage the opening thus the integrated, exposed conductive elements to facilitate the coagulation process and ensure the lesions created are consistent, continuous, and transmural.

Abstract: The present invention relates to ablation electrode assemblies. The present invention further relates to an irrigated ablation electrode assembly that includes a recessed portion that can improve fluid flow around the irrigated ablation electrode. The electrode includes an outer body portion having an outer surface, and an inner cavity defined within the outer body portion. The electrode further includes at least one passageway for fluid flow from the inner cavity to the outer surface of the body of the electrode. The passageway further defines an outlet on the external surface of the electrode, therein allowing the fluid to flow on and/or around the electrode surface. The outer surface of the electrode further includes a recessed portion. The outlet of the passageway is disposed at least partially within the recessed portion. The fluid that exits the passageway may flow within the recessed portion to improve irrigation of the electrode.

Abstract: An adapter includes a coupling mechanism that mates with a protruding nozzle of a gas-enhanced electrosurgical coagulation handpiece to convert the coagulation handpiece into a gas-enhanced electrosurgical cutting instrument. An adapter electrode and flow passageways of the adapter conduct electrical energy and gas from the nozzle of the coagulation handpiece to a protruding cutting end portion of an adapter electrode.

Abstract: An electrosurgical generator for supplying electrosurgical energy to tissue is disclosed. The generator includes sensor circuitry configured to measure at least one tissue or energy parameter and a controller configured to generate a plot of the at least one tissue or energy parameter including a plurality of tissue parameter values, wherein the controller is further configured to normalize the plot of the at least one tissue or energy parameter with respect to treatment volume.

Abstract: A medical device system and method provide an RF electrosurgical generator coupled to an electrosurgical electrode via a patient box disposed in close proximity to the patient. An RF signal is delivered from the generator to the patient box where signal power is increased and the RF signal delivered to the electrosurgical electrode. The patient box is coupled to the electrosurgical electrode by a short cable capable of carrying an HV, high frequency 5 MHz signal without leakage. An electrical characteristic associated with the electrosurgical electrode is monitored and a desired RF power output and duty cycle maintained by adjusting DC input voltage applied to an RF amplifier, responsive to the monitoring. The system determines when the electrosurgical cutting electrode has started cutting and switches from a start mode to a run mode having a different RF duty cycle and a reduced RF power output controlled by a servo system.

Abstract: Pieces of tissue are fused together and simultaneously cut by compressing the pieces together at an interface, delivering an impulse of electrical power which is converted into sufficient thermal energy to fuse the pieces together at the interface and simultaneously cut the fused tissue pieces along a well-defined linear path. The impulse, and the fusion and the simultaneous cutting, occur within a preferable time of 1.5-2.0 seconds but no greater than 4.0 seconds. The temperature of the thermal energy is regulated between 220° C.-320° C. The force applied on the tissue pieces is sufficient to fuse the tissue at the interface followed by further compression to cut the fused tissue along the linear path as a result of the thermal energy and a zero distance gap between jaws which compress the tissue pieces. The jaws have smooth working surfaces with an Ra of 0.15 or less microns up to 0.40 microns.

Abstract: Pieces of tissue are fused together by compressing the pieces together at an interface, delivering an impulse of electrical power which is converted into sufficient thermal energy to fuse the pieces together at the interface. The impulse and the fusion occur within a preferable time of 0.5-2.0 seconds but no greater than 4.0 seconds. The temperature of the thermal energy is regulated between 150° C.-200° C. The tissue pieces are compressed to a thickness of 0.05-0.10 mm. Jaws which compress the tissue and transfer the energy have smooth working surfaces with an Ra of 0.15 or less microns to 0.40 microns.

Abstract: A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

Abstract: A control system for use with an electrosurgical generator which delivers electrosurgical energy to tissue has a control module. The module includes a processor executing an algorithm. The algorithm has the steps of determining a sensed voltage value corresponding to a sensed voltage signal output by the electrosurgical generator and determining a sensed current value corresponding to a sensed current signal output by the electrosurgical generator. The algorithm has the steps of determining phase information corresponding to a phase shift between the voltage signal and the current signal and determining a characteristic related to the electrosurgical energy delivered to the tissue using the phase information, the sensed voltage value and the sensed current value.

Abstract: A catheter for ablating tissue is provided. The catheter comprises an elongated generally-tubular catheter body having proximal and distal ends. An electrode assembly is provided at the distal end of the catheter body. The electrode assembly including a porous electrode arrangement that is generally transverse to the catheter body. The porous electrode arrangement comprises one or more electrodes electrically connected to a suitable energy source and a porous sleeve mounted in surrounding relation to the one or more electrodes and defining an open space between the porous sleeve and the one more electrodes. One or more irrigation openings fluidly connect the open space to a lumen extending through the catheter through which fluid can pass. In use, fluid passes through the lumen in the catheter, through the one or more irrigation openings, into the open space and through the porous sleeve.

Abstract: Devices and methods are described for ablation of cardiac tissue for treating cardiac arrhythmias, such as atrial fibrillation. Devices may include a tissue contacting member for contacting epicardial tissue and securing the ablation device to the epicardial tissue and an ablation member for ablating the tissue. Suction apertures attach the contacting member to the epicardial surface with sufficient strength to stabilize the tissue with the device. The devices and methods can be used to ablate epicardial tissue in the vicinity of a pulmonary vein or to ablate cardiac tissues in other locations on a heart. A combined pacing and ablation probe is described for treating cardiac arrhythmia by: advancing the probe through an incision into the vicinity of the patient's heart, verifying at least one location of a cardiac parasympathetic ganglion, and applying ablation energy to the cardiac parasympathetic ganglion.

Abstract: Methods, medical probe kits, and systems are provided for treating a tissue region within a patient, e.g., a margin of tissue surrounding an interstitial space created by removing abnormal tissue. A delivery cannula is introduced within the patient. A hydrophilic electrode is advanced through the cannula adjacent the tissue region, e.g., within the interstitial cavity. An ablation probe is advanced though the cannula into contact with the hydrophilic electrode, and ablation energy is conveyed from the ablation probe into the tissue region via the hydrophilic electrode.

Abstract: A high-frequency treatment instrument 1 comprises a flexible tube 3 which is inserted into a body cavity and a treatment portion 2 which is located on the distal end of the flexible tube 3 when a high-frequency current is applied. In this high frequency treatment instrument 1, the flexible tube 3 is formed by a plurality of wound conductive wires and is provided with a multiple-thread coil 6 connected electrically to the treatment portion 2, and the high-frequency current is applied to the multiple-thread coil 6.

Abstract: A catheter is provided with an anchoring member for anchoring a part of a linear ablating head of the catheter to a structure. The structure can be a cryogenically anchored point catheter. This allows the surgeon to position the linear catheter more exactly in the heart chamber and overcomes the adverse effects of the slippery and irregular heart chamber walls.

Abstract: Ablation performance indicator for electrosurgical devices is described where ablation is typically characterized by the generation of a plasma discharge at the electrode assembly of an electrosurgical probe. When the electrode begins firing, the current waveform assumes a distinct appearance characterized by a spike at the leading edge of each half cycle followed by a lower level for the remaining period of the half cycle. A calculation of the waveform's Crest Factor can be used to determine the state at the electrode, e.g., whether the ablative energy is causing a desirable ablative effect on the electrode. This provides real-time measurements of the RMS and peak current amplitudes along with the Crest Factor and may also be used as limits or inputs to control algorithms or as inputs to indicate whether the device is in its ablative or non-ablative state.